Clinical Outcomes of a Modified Laryngeal Mask Airway (LMA^® Gastro™ Airway) During Esophagogastroduodenoscopy in Children and Adolescents: A Randomized Study

Figures & data

Figure 1 The LMA^® Gastro™ Airway has a second channel with an entrance at the top (black arrow) for endoscope insertion. This channel exists from a posterior site at its distal end (red arrow) to facilitate endoscope passage into the esophagus and avoid the need to navigate around the cuff. There is also a standard 15 mm adaptor (black circle) for attachment to the anesthesia circle system.

Figure 2 Ambu^® AuraOnce™ laryngeal mask airway used for the study which has a single channel for ventilation that sits over the top of the glottic inlet.

Table 1 Demographic Data of the Study Cohorts

Variables	All (n = 200)	LG Group (n = 100)	AA Group (n = 100)	P value
Gender, female, n (%)	110 (55)	56 (56)	54 (54)	0.776
Age (years)	13.6 ± 2.95	13.7 ± 2.98	13.5 ± 2.94	0.775
Weight (kilograms)	56.6 ± 17.4	55.9 ± 18.2	57.1 ± 16.8	0.630
Height (centimeters)	158.9 ± 13.3	158.4 ± 13.1	158.7 ± 13.2	0.869
Body mass index (kg/m^2)	22.1 ± 5.02	22 ± 4.93	22.3 ± 4.98	0.649
LMA size (2.5, 3, 4, 5)	2 (1), 116 (58), 80 (40), 2 (1)	1 (1), 62 (62), 36 (36), 1 (1)	1 (1), 54 (54), 44 (44), 1 (1)	0.826

Note: Data are presented as mean ± standard deviation or number (%).

Abbreviations: LMA, laryngeal mask airway; LG, LMA^® Gastro™ Airway; AA, Ambu^® AuraOnce™.

Table 2 Outcomes of EGD Scope Insertion According to Type of Laryngeal Mask Airway Used.^a

Outcomes	LG Group (n = 100)	AA Group (n = 100)	P value
More than one attempt	3 (3%)	1 (1%)	0.369^b
Significant gas leak around cuff	2 (2%)	3 (3%)	1.000^b
Blood found on LMA or in oropharynx	11 (11%)	4 (4%)	0.105^b
Difficulty with ventilation	1 (1%)	3 (3%)	0.621^b
Time from EGD placement to stomach entry (<1 minute and ≥1 minute)	68 and 32	66 and 34	0.764^c
Ease of EGD procedure (VAS)	10 (8, 10)	9 (8, 9)	<0.001^d
Throat soreness prior to discharge (VAS)	3 (2, 3.5)	3 (2, 3)	0.036^d
Throat soreness on first postoperative day (VAS)	2 (1, 3)	2 (1, 3)	0.702^d
Intracuff pressure following anesthetic induction, prior to endoscope insertion (cmH2O)	43 (14)	38 (14)	0.020^e
Maximum intracuff pressure after endoscope insertion	50 (16)	47 (16)	0.226^e
Change in intracuff pressure following endoscope insertion (compared to baseline in cmH2O)	7 (7)	9 (8)	0.045^e
Intracuff pressure >60 cmH2O	22 (22%)	14 (14%)	0.141^c

Notes: ^aData are presented as N (%), median (IQR), or mean (SD). ^bFisher’s exact test. ^cChi-square test. ^dWilcoxon rank sum test. ^eT-test. VAS scale is listed as 1 to 10 (10 being easiest procedure and severe pain for throat soreness).

Abbreviations: EGD, esophagoduodenoscopy; IQR, interquartile range; LMA, laryngeal mask airway; SD, standard deviation; VAS, visual analog scale; LG, LMA^® Gastro™ Airway; AA, Ambu^® AuraOnce™.